2nd opinion

Hi I am looking for some advice. I have ticked all the boxes for endometriosis and been trying for a baby for 2 years with no joy. All the other relevant tests have been done. Yesterday I had my laparoscopy and dye test done however they only put the dye through my fallopian tubes and checked my womb and fallopian tubes and ovaries. They have said their is no signs of endometriosis. I am convinced it's on my bowels but I don't no Wether that woukd stop me conceiving. I was going to ask for a 2nd oppion but don't no what to do or just leave it. 

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  • Hi - where are you in the UK as options vary?

  • Hi I stay in glasgow 

  • That's a shame as unfortunately you don't have the same freedom of choice in Scotland as in England. At this point in England you would just seek referral to a specialist endo centre for a second opinion.

    Yoor lap is exactly what I suspected was happening in general gynaecology because they are obstetricians and primarily concerned with fertility. There is a detailed procedure to be followed at a diagnostic lap as confirmed in the ESHRE guidelines that underpin NHS treatment and this is as follows: 

    '1.3.1 Laparoscopy in the diagnosis of endometriosis

    A good quality laparoscopy should include systematic checking of:

    1) The uterus and adnexa (ovaries and Fallopian tubes.)

    2) The peritoneum of ovarian fossae, vesico-uterine fold, Douglas and pararectal spaces.

    3) The rectum and sigmoid (isolated sigmoid nodules.)

    4) The appendix and caecum.

    5) The diaphragm.

    There should also be a speculum examination and palpation of the vagina and cervix under laparoscopic control, to check for 'buried' nodules. A good quality laparoscopy can only be performed by using at least one secondary port for a suitable grasper to clear the pelvis of obstruction from bowel loops, or fluid suction to ensure the whole pouch of Douglas is inspected.’

    Clearly this hasn't been followed. What I suggest is that you obtain the report of the lap so we actually have it in writing from the gynaecologist what they did (or more to the point, didn't do), then when it is clear that this hasn't all been done we can compose a polite letter to them asking why it wasn't followed and on what basis they are able to confirm you don't have endo affecting these other areas.

    I'm working on an action plan for tackling these gynaecologists in Scotland, Wales and NI and think this is the best starting point in cases like yours.

    What symptoms do you have to suggest bowel involvement - do you have any pain with/after sex (if you are sexually active), lower back pain, referred pain anywhere else, IBS type symptoms?

  • Do you have an email address and I could email you?

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